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111 Ferns Way M OPERATION PERMIT ;7; use n v Davie County Health. Department er, .122800-1 , ,.. 210 Hospital Street iP.O. Box 848 r:Mocksville NC, 27028 ISTING Phone:336-753-6780 Fax:336-753-1680 7Applicant: Eddie L. Nuckols Property Owner. Eddie L. Nuckols Address: Boone Farm Road Address: 163 Boone Farm Road City: Mocksville City: Mocksville State/Zip: NC 27028 State2ip: NC 27028 Phone#: (336)492-7619 Phone#: (336)492-7619 Property Location & Site Information rAddress/Road#: Subdivision: Phase: Lot: ne Farm Roadle NC 27028 Directions Structure: SINGLE FAMILY hwy 64 West then left on Boone Farm Road. #of Bedrooms: Property on left #of People: ,Water Supply: NIA 'IP Issued by. *System Classification/Description: 'CA issued by: Saprolite System? OYes ®No Design Flow: 3 6 0 'Distribution Type: GRAVITY-SERIAL Pump Required? OYes )No Soil Application Rate: 0 - 3 'Pre Treatment: Drain field rNkrifiotion Field 1 2 0 0 Sq.ft. "System Type: INFILTRATOR QUICK 4 STANDARD n Lines 4 Installer. Randy Miller Total Trench Length: 3 0 0 Certification#: 1128 Trench Spacing: _ 9 Inches O.C. ,�, *Feet O.C. 'EHS: 2140-Nations,Robert Trench Width: _ 3 Olnches • Feet Date: 1 2 / 1 7 / 2 0 1 4 Aggregate Depth: inches Minimum Trench Depth: a $ Inches Minimum Soil Cover. 1 6 .Appn6val Statu"s Inches �. �� p r Maximum Trench Depth '3 6 Inches ® f/�pprove°d C� Dlsapplroved ftDrkA Maximum Soil Cover. 4 Inches CDP File Number 122800- 1 Septic Tank County ID Number:, 13.000.00.035.02 Manufacturer. Shoat Let.: - STB: 760 Long �,—. - Gallons: 1000 InstallerRandy Miller Certification#: 1128 Date: 0 g / 1 6 / a 0 1 4 *EHS: 2140-Nations.Robert *Filter Brand: POLYLOK PL-122 With Pipe Adapter 1 2 / 1 7 / a $ 1 4 ST Marker. El Yes R No Date: p "' ,�qpPro'i Wtus Reinforced Tank: ❑ Yes 0 NO 1 Piece Tank: ❑ Yes [ No C °FApproVed D Disapproved Pump Tank Manufacturer. Installer PT: Certification#: Gallons: 'EHS: Date: I / Date: / RiserSeeled ❑ Yes ❑ No RiserHeight: ElYes ❑ No (Min.6 in.) ApprovalStatus s Reinforced Tank: ❑ Yes El No .,`❑ Approv+ed rlDisapproved 1, 1 Piece Tank: El Yes ❑ No - Supply Line CPipe Size: inch diameter Installer. Pipe Length: feet Certification#: 'Schedule: "EHS: Pressure Rated ❑ Yes ❑ No Date:. / Approved fittings ❑ Yes ❑ NO Approval Status Approved❑ Disapproved P^ Pump Requirement Pump Type: Installer. Dosing Volume: - Gal Certification#: Draw Down: Inches *EHS' *Chain: Date: Valves Accessible ❑ Yes ❑ No Flow Adjustment Valve ❑ Yes ❑ No Check-valve ❑ Yes ❑ NO Apprwai status a PVC Unions ❑ Yes ❑ No. ❑ Approved O Disapproved Vent Hole ❑ Yes ❑ No ,., T E, . § a Anti-siphon Hole ❑ Yes 0 NO OPERATION PERMIT or flice use n v Davie County Health Department *CDP:File:Number 122800-1 210 Hospital Street t3.000;00-03"2 P.O.Box 848 County ID Number:; Mocksville- NC: 27028: Evaluated,For. EXISTING Phone:336-753-6780 Fax:336-753-1680 Township: Applicant: Eddie L. Nuckols Property Owner. Eddie L. Nuckols Address: Boone Farm Road Address: 163 Boone Farm Road City: Mocksville City: Mocksville State2ip: NC 27028 State0p: NC 27028 Phone#: (336)492-7619 Phone#: (336)492-7619 Property Location & Site Information Add7ress/Road#: Subdivision: Phase: lot: 163 Boone Farm Road Mocksville NC 27028 Directions Structure: SINGLE FAMILY hwy 64 West then left on Boone Farm Road. #of Bedrooms: Property on left #of People: 'Water Supply: NIA *IP Issued by. 'System Classification/Description: *CA issued by: Seprolite System? OYes *No Design Flow: 3 6 0 *Distribution Type: GRAVITY-SERIAL. Pump Required? OYes ('&No Soil Application Rate: 0 - 3 *Pre Treatment: Drain field rNknificati,onField 1 a 0 0 Sq.ft. *System Type: INFILTRATOROUICK4STANDARD Lines 4 Installer: Randy Miller Total Trench Length: 3 0 0 ft. Certification#: 1128 Trench Spacing: 9 Qlnches O.C. • Feet O.C. *EHS: 2140-Nations.Robert Trench Width: — 3 Olnches feet Date: 1 a / 1 7 / a 0 1 4 W W Aggregate Depth: inches Minimum Trench Depth: a 8 Inches Minimum Soil Cover. 1 fi Appro t talus Inches Maximum Trench Depth: -3 5 ® ji4pprorec CDiapproVed Inches . n. ,r Maximum Soil Cover. a 4 Inches CDP Fite Number 122800- 1 Septic Tank County ID Number:, 13.000-00-035.02 Manufacturer: Shoat Lat. STB: 760 Long: Gallons: 1000 InstallerRandy Miller Certification#: 1128 Date: 0 $ / 1 6 � a D 1 4 THS: 2140-Nations.Robert *Filter Brand: POLYLOK PL-122 With Pipe Adapter ST Marker. El Yes ® No Date 3 x / 1 7 / 0- 0 1 4 Reinforced Tank: ❑ YeS BNO = Approval Status ;pi ® Approved❑ -Disapproved 1 Piece Tank: ❑ Yes ® No = Pump Tank Manufacturer. Installer. PT: Certification#: Gallons: 'EHS: Date: / / Date: Risersealed ❑ Yes ❑ No RiserHeUht: ❑ Yes ❑ No (Min.6in.) y Appy slStatus �� Reinforced Tank: ❑ Yes ❑ No ❑s Approved❑<;Disapprovetl 1 Piece Tank: ❑ Yes ❑ No _ Supply Line FP!Opeize: inch diameter Installer gth: feet Certification#: Schedule: *EHS: Pressure Rated ❑ Yes ❑ No Date: Approved fittings ❑ Yes ❑ No Approval Status zQ ❑~,Approved❑n Dlsa �rove Pump Requirement Pump Type: Installer. Dosing Volume: - Gal Certification#: Draw Down: Inches THS: *Chain: Date: Valves Accessible ❑ Yes ❑ No Flow Adjustment Valve ❑ Yes ❑ No Check valve ❑ Yes ❑ N o FWwai Status+ , PVC Unions [:1 Yes . ElNo ❑ Appr!ovd Q Dtspproved Vent Hole ❑ Yes ❑ No , w Anti-siphon Hole ❑ Yes ❑ No 1228x0 -9 13.000-00-035-02 CDP Fite Number County ID Number: Electric Equipment NEMA4XBoxorEquivalent ❑ Yes ❑ NO Installer. Box 12 inches Above Grade ❑ Yes ❑ NO Certification#: Box Adj.To Pump Tank ❑ Yes ❑ NO Conduit Sealed ❑ Yes ❑ No *EH S: Pump Manually Operable ❑ Yes ❑ No 'Activation Method: Date: 1 Approval Status i Alarm Audible ❑ 'Yes ❑ No Alarm Visible El Yes ❑ No ❑'��pProt ❑�xDtsappred 2140-Nations,Robert *Operation Permit completed by: Authorized State Agent�C � _ -^., _-� Date of Issue. 1 a / 1 / a 0 1 4 Owner/Applicant Signature: This system has been installed in compliance with applicable NC General Statutes:Article 11,Chapter 130A, Rules for Sewage Treatment and Disposal,15A`NCAC 18A.1900 et.Seq.,,and all conditions of the Improvement Permit and Construction Authorizetidii This property is served by.a sewage Septic system'.. Rule.1961 requires that a Type septic system meet the following criteria: Minimum System Review ByThe Local Health Department: Management Entity: Minimum System Inspection/Maintenance Frequency By Certified Operator. Reporting Frequency By Certified Operator. Rule.1961 requires that a Type IV and V septicsystems designed for a home/business owner must maintain a valid contract With a public management entitywth a certified operator ora private certified operatorfor the life of the septic system. Rule.1961 requires that Type VI septic systems designed for a home/business owner must maintain a valid contract with a public management entity with a certified operator for the life of the septic system. Rule.1961 (2)(e)requires a contract shall be executed between the system owner and-a management entlypriorto the, issuance of an Operation Permit for a system required to be maintained bya public or private management entity,unless the system owndrand certified operatorare the same. The contract shall require specific requirements formaintenance and operation, responsibilities of the ownerand systems operator;provisions that the contract shall be ineffectfor as long as the system is in use,and other requirements for the,continued proper performance of the system. R shall also be 11 a condtion of 'the Operation Penn it that subsequeitfowners`of the systems execute such a contrract. @Hand Drawing 0importDrawing **Site Plan/Drawing attached.** �" OPERATION PERMIT Davie County Health Department CDP`File Number: 122840 i 9 210 Hospital Street 13-000-00-03S-02P.O.Box 848 County File Number: Mocksvilie NC 27028 Date: Olnch Dmwiin O Drawing Type: Operation Permit Scale: ON A k � o T1 L6 A y FI I —J-1 0 e CONSTRUCTION For office Use Only AUTHORIZATION *CDP File Number 122800-1 •"�"' Davie County Health Department 13-000-00-03x02 tY P County ID Number. t 210 Hospital Street Evaluated For. EXISTING P.O. Box 848 Township: Mocksville NC 27028 PERMIT VALID UNTIL: Phone:336-753-6780 Fax:336-753-1680 1 0 a 3 2 0 1 8 Applicant: Eddie L. Nuckols Property Owner. Eddie L. Nuckols Address: 163 Boone Farm Road Address: 163 Boone Farm Road City: Mocksville City: Mocksville State2ip: NC 27028 State/Zip: NC 27028 Phone#: (336)492-7619 Phone#: (336)492-7619 Property Location &Site Information Address/Road#: Subdivision: Phase: Lot: 163 Boone Farm Road Mocksville NC 27028 Directions Structure: SINGLE FAMILY hwy 64 West then left on Boone Farm Road. Property on left #of Bedrooms: #of People: *Water Supply: NSA - System Specifications Minimum Trench Depth: a 4 Site Classification: Ps Inches Minimum Soil Cover. Saprolite System? OYes (9 No Inches Design Flow: 3 6 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 3 Maximum Soil Cover. Inches *System Classification/Description: *Distribution Type: GRAVITY-SERIAL TYPE II A.CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) Septic Tank: 1 0 0 0 Gallons *Proposed System: 25019 REDUCTION 1-Piece: O Yes ®No Pump Required:. O Yes ®No O May Be Required Nitrification Field Sq.ft. Pump Tank: Gallons No. Drain Lines 1-Piece: OYes ONo Total Trench Length: 3 0 0 ft GPM vs— ft. TDH Trench Spacing: OFeet O.C. g Inches O.C. _ Dosing Volume: _ Gallons O Trench Width: _ OInches O Feet Grease Trap: Gallons Aggregate Depth: inches Pre-Treatment: O NSF OTS-1 O TS-I1 Septic Tank Installer Grade Level Required: 01 Oil 0111 OIV Page 1 of 3 CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital Street. 122800 - 1 CDP File Number: P.O.Box 848 13-000-00-035-02 Mocksville NC 27028 County File Number: Date: .1.0./ a 3 V2 0 13 Click below to import an image from an external location: Drawing Type:Construction Authorization Page 3 of 3 P1 P2 y CONSTRUCTION AUTHORIZATION 122800 - 1 Davie County Health Department CDP File Number: 210 Hospital Street 13-000-00-035-02 P.O.Box 848 County File Number: Mocksville NC 27028 Date: 10 / 23 / .2013 Q Inch Drawing Drawing Type: Construction Authorization Scale: • 00 Block ft. Q� C z3 60 261 &71 lid 16 4—> Page 3 of 3 _ P1 P2 Y I � Llp � Ne 0 CONSTRUCTION For office Use Only AUTHORIZATION *CDP File Number 122800-1 Davie County Health Department County ID Number: 13-000-00-035-02 210 Hospital Street Evaluated For: EXISTING •mow . P.O. Box 848 Township: Mocksville NC 27028 PERMIT VALID UNTIL: Phone:336-753-6780 Fax:336-753-1680 1 / a 3 0 1 8 Applicant: Eddie L. Nuc kolsProperty Owner: Eddie L.Nuckols Address: 163 Boone Farm Road Address: 163 Boone Farm Road City: Mocksville City: Mocksville State/Zip: NC 27028 State/Zip: NC 27028 Phone#: �336'492-7619 Phone#: (336)492-7619 Property Location & Site Information Address/Road#: Subdivision: Phase: Lot: 163 Boone Farm Road Mocksville NC 27028 Directions Structure: SINGLE FAMILY hwy 64 West then left on Boone Farm Road. Property on left #of Bedrooms: #of People: *Water Supply: NSA System Specifications Minimum Trench Depth: a 4 rDesign ssification: Ps Inches System? Minimum Soil Cover: y OYes lgNo Inches low: 3 6 0 Maximum Trench Depth: 3 6 Inches Soil Application Rate: 0 . 3 Maximum Soil Cover: Inches *System Classification/Description: *Distribution Type: GRAVITY-SERIAL TYPE II A.CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR LESS) Septic Tank: 1 0 0 0 Gallons *Proposed System: 25%REDUCTION 1-Piece: O Yes (9 No Pump Required: O Yes (&No O May Be Required Nitrification Field Sq.ft. Pump Tank: Gallons No. Drain Lines 1-Piece: OYes ONo Total Trench Length: 3 ® 0 ft GPM—vs— ft. TDH Trench Spacing: g Q Inches O.C. Dosing Volume: _ Gallons . 8Feet O.C. Trench Width: _ OInches O Feet Grease Trap: Gallons Aggregate Depth: inches Pre-Treatment: O NSF OTS-1 OTS-11 Septic Tank Installer Grade Level Required: 01011 O 111 O IV Page 1 of 3 CDP File Number •122$00 - 1 County ID Number: 13-000-00-035-02 ❑ Open Pump System Sheet Repair System Required:®Yes ONO ONO, but has Available Space CDesign System Trench Spacing: O Inches O.C. fication: PS — Q Feet O.C. Trench Width: O Inches w: 3 IJ 0 _ Q Feet Soil Application Rate: 0 3 Aggregate Depth: inches Minimum Trench Depth: a 4 Inches *System Classification/Description: TYPE II A.CONV SYSTEM(SINGLE-FAMILY OR 480 GPD OR Minimum Soil Cover: LESS) Inches Maximum Trench Depth: 3 6 Inches *Proposed System: 25%REDUCTION Maximum Soil Cover: Nitrification Field Inches Sq.ft. No. Drain Lines *Distribution Type: GRAVITY-SERIAL TotalTrench Length: 3 0 0 ft Pump Required: QYes ®No QMay Be Required Pre-Treatment: O NSF OTS-I OTS-II *Site Modifications No grading or construction activity is allowed in areas designated for system and repair without approval of Health Department. *Permit Conditions The issuance of this permit by the Health Department in no way guarantees the issuance of other permits.The permit holder is responsible for checking with appropriate governing bodies in meeting their requirements. This Authorization for Wastewater System Construction shall be valid for a person equal to the period of validity of the Improvement Permit,not to exceed five years,and may be Issued at the same time the Improvement Permit Issued(NCGS 130A336(b)).If the Installation has not been completed during the period of validity of the Construction Permit,the Information submitted In the application for a permit or Construction Authorization Is found to have been incorrect,falsified or changed,or the site is altered,the permit or Construction Authorization shall become Invalid,and may be suspended or revoked(.1937(g)).The person owning or controlling the system shall be responsible for assuring compliance with the laws,rules,and permit conditions regarding system location,installation,operation,maintenance,monitoring,reporting and repair (1938(b)). Applicant/Legal Reps. Signature Required? O Yes ®No Applicant/Legal Reps.Signature: Date: *Issued By: 2244-Daywalt,Andrew Date of Issue: 1 0 .2 3 / .2 0 1 3 Authorized State Agent: ad(A Malfunction Log Oyes (&Hand Drawing O Import Drawing Total Time:(HH:MM) **Site Plan/Drawing attached.** 0 0 Hours 3 0 Minutes Page 2 of 3 S-8-CA'S issued-new CONSTRUCTION AUTHORIZATION Davie County Health Department CDP File Number: 122800 - 1 210 Hospital Street 13-000-00-035-02 P.O.Box 848 County File Number: Mocksville NC 27028 Date: 10 / a3 / ,2013 O Inch Drawing Drawing Type: Construction Authorization Scale: . O Block O N/A Q D16 Zd D' Vft $%%-ZT 10 � Page 3 of 3 P1 P2 CONSTRUCTION AUTHORIZATION Davie County Health Department 210 Hospital street CDP File Number: 122800 - 1 P.O.Box 848 13-000-00-035-02 Mocksville NC 27028 County File Number: Date: .1 O,/ a 3 / a 0 13 Click below to import an image from an external location: Drawing Type: Construction Authorization Page 3 of 3 P1 P2 w APPLICATION FOR SITE EVALUATIONAMPROVEMENT PERMIT & ATC Davie County Environmental Health r• ?l P.O.Boz 848/210 Hospital Street Mocksville,NC 27028 (336)753-678 Fax(336)753-1680 to 13 ee Application For: Site Evaluation/Improvement Permit [B'AuthorizationTo Construct(ATC) ❑Both Type of Application: ❑New System ❑Repair to Existing System ❑Exuansion/Modification of Existing System or Facility ***IMPORTANT***THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL OF THE REQUIRED INFORMATION IS PROVIDED. Refer to the INFORMATION BULLETIN for instructions. APPTJC;ANT TNFORMATION Name i e-k o I.$ Contact Person /C d d-L- N uL K a 15 Address lb 3dbavt, Foorm Kd . Home Phone 6330 49 Z`7 4 1 8 City/State/ZIP A oeKs v; C 270 Z8 Business PhoneC�el [336)993 38Z O _ Email ecidif vc.kolS � Uahoo.Cam Name on Permit/ATC if Different than Above Mailing Address City/State/Zip PROPERTY INFORMATION r *Date House/Facility Comers Flagged NOTE: A survey plat or site plan must accompany this application. Included: ❑ Site.Plan ❑Plat(to scale) (Permit is valid for 60 months with site plan,no expiration with complete plat.) Owner's Name'&d d;J.NUC-6 1 S ' Phone Number Owner's AddressAo3 Boone Fat,m Ad. ...City/State/Zip/1�otksv,Ar, VC 27DZf Property Address $A Irl E h5 A 130 V E City Lot.Size1 Gere- Tax PIN# T3-060-00-03 S'- Subdivision Name(if applicable) Section/Lot# fe Directions To Site: We4 Aa n -F o A R—eaptrat- If the answer to any of the following questions is"Yes",supporting documentation must be attached: Are there any existing wastewater systems on the site? ✓Yes No Sep11 iC1C h a"",,' Does the site contain jurisdictional wetlands? Yes ✓No Are there any easements or right-of-ways on the site? ✓yes No br1%fewcul Is the`§iCq bject to.approval by another public agency? Yes ✓No Will wastewater other than domestic sewage be generated? Yes ✓No TF RESIDENCE PITS,01 JT THF BOX BELOW #People s #Bedrooms _ #Bathrooms Garden Tub/Whirlpool ❑Yes &No Basement: ❑Yes UWo Basement Plumbing: ❑Yes fi b IF NON-RESIDENCE FI.J.,OUT THF,BOX.DFd.OW Type of Facility/Business Total Square Footage of Building #People #Sinks #Commodes #Showers #Urinals Estimated Water Usage(gallons per day) (Attach documentation of similar facility water consumption) FOODSERVICE ONLY: #Seats Type system requested: E onventional ❑Accepted ❑Innovative ❑Alternative ❑Other Water Supply Type: ErCounty/City.Water ❑New Well ❑Existing Well ❑ Community Well Do you anticipate additions or expansions of the facility this system is intended to serve?TT Yes P-110- If yes,what type? This is to certify that the information provided on this application is true and correct to the best of my knowledge. I understand that any permit(s)or ATC(s)issued hereafter are subject to suspension or revocation if the site is altered,the intended use changes,or if the information submitted in this application is falsified or changed I hereby grant right of entry to the Authorized Representative of the Davie County Health Department to conduct necessary inspections to determine compliance with applicable laws and rules. I understand that I am responsible for the proper identification and labeling of property lines and corners and locating and flagging =T;Tous facili to5plion,proposed well location and the location of any other amenities. Property owner's or owner's legal representative signature Site Revisit Charge Date(s): t301?=Q13 Client Notification Date: Date EHS: Sign given ❑Yes ❑No `� Account# Revised 11/06 11/06 Invoice will tno'l el 25-C� t � 152 5 r 5ti n'� - r' 2 1 i -y. O i l C l \V tE 0U 14 K. Printed:Jul 30, 2013 All data is provided as is without warranty or guarantee of any kind either expressed or implied including but not limited to the implied warranties of merchantability or fitness for a particular use. All users of Davie County's GIS website shall hold harmless the County of Davie, North Carolina,Its agents,consultants,contractors or employees from any and all claims or causes of action due to or arising out of the use or inability to use the GIS data provided by this website. ' DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section • Soil/Site Evaluation • APPLICANT INFORMATION PROPERTY INFORMATION iFzt011 Q,L-IV cte,k oIs T3-DD0�- 3S�Z �oaNr _ 1'e, 2 Water Supply: On-Site Well Community Public V Evaluation By: Auger Boring X Pit Cut FACTORS 1 2 3 4 5 6 7 Landscape position . L Slope % O HORIZON I DEPTH $ Texture group Consistence O Structure W Q Mineralogy ; HORIZON H DEPTH k Texture group Consistence FR PR n Structure _IUY- SOIL Mineralogy ` .l HORIZON III DEPTH Texture group Consistence Structure Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION 125p LONG-TERM ACCEPTANCE RATE SITE CLASSIFICATION: F-5 EVALUATION BY: d LONG-TERM ACCEPTANCE RATE: OTHER(S)PRESENT: REMARKS: LEGEND Landscape Position R-Ridge S-Shoulder L-Linear slope FS-Foot slope N-Nose slope CC-Concave slope CV-Convex slope T-Terrace FP-Flood plain H-Head slope Texture S-Sand LS-Loamy sand SL-Sandy loam L-Loam SI-Silt SICL-Silty clay loam SIL-Silty loam CL-Clay loam SCL-Sandy clay loam SC.-Sandy clay SIC-Silty clay C-Clay CONSISTENCE, Moist VFR-Very friable FR-Friable FI-Firm VFI-Very firm EFI-Extremely firm NS -Non sticky SS -Slightly sticky S -Sticky VS-Very Sticky NP-Non plastic SP-Slightly plastic P-Plastic VP-Very plastic Structure SC-Single grain M-Massive CR-Crumb GR-Granular ABK-Angular blocky SBK-Subangular blocky PL-Platy PR-Prismatic. Mineralogy 1:1,2:1,Mixed NQtm Horizon depth-In inches Depth of fill-In inches Restrictive horizon-Thickness and inches from land surface Saprolite-S(suitable);U(unsuitable) Soil wetness-Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less Classification-S(suitable),PS(provisionally suitable),U(unsuitable) T TAR -T nnv_tP..rm nrrP.ntnnri rate- oat/dnxi/fO TrTTr�nc1nc in -� L 69 9L-l NVAV-1 03-Aom :H39WnN ONIM"(3 :3WVN 02 000 :3YVVN 3-11 3 .90,LS.£L S iL'i9 9£'£Zt t'ti'£Zi ZO'L9St .if,0£+y ZO JogwnN uogD,1s160a J nS 3 LO.LGJRL S 60'SL 00'09 t 90'09 t Z0'L9S t ,Z t,6Z.9 t0 y C in;Du61S 0218 0210HO 1N30NV1 0210HO Oily SnI0V21 V1130 3A21nO / 133J NI 3�b�OS N0211 •OAogo •p 46noJ41 •D ul poumquoO s IB 8D D lD • ;o,d DNIlSIX3 �(w ;0 1sGq 041 0; uo.4DUIwJG;op o ow o1 olgoun WD 1 1044 yone el JodoA,ns sly; 01 GlgDIIDAD UO11DUUOIUI Gta 1041 •e OSI OOI OS Q SZ OS :uolelnlpgns o )o uo111u1 epp 041 o} uogdoOxG Joy;o Jo 'Amins pOJop,o-}.moa D '8180,00 6ugelxo ;o UO.gDulgwooaJ ,OS = „L I 041 80 tone 'AJo69100 J041OUD 10 AoA,ns D ;o sl 1DId alta 1041 'P Dd ZLCO-A #WHI_i S` 18< 82',GS #41110 I !a . 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